Pharm 5 Flashcards
Anti-androgen used for hirsutism in females
Cyproterone acetate
Alpha cells in the pancreas
Produce glucagon
Beta cells in the pancreas
Produce insulin
Beta cells are found
Islets of Langerhans - centrally
Delta cells in the pancreas
Produce Somatostatin
Endogenous insulin
Normal C-peptide
Very rapid acting insulin, having fastest onset and shortest duration of action
Lispro & Aspart
Short acting, crystalline zinc insulin used to reverse acute hyperglycemia
Regular (Humulin R)
Ultra long acting insulin, has over a day duration of action
Glargine (Lantus)
Major SE of insulin
Hypoglycemia
Transporter of glucose –> liver for glycogen synthesis
GLUT 2
Transporter of glucose –> muscle and adipose –> TG storage and activation of LPL
GLUT 4
Examples of alpha-glucosidase inhibitors (AGI)
Acarbose, miglitol
MOA of AGI’s
Inhibit brush border enzyme in intestine–> delay absorption of glucose –> dec post-prandial hyperglycemia
SE of AGI’s
Flatulence (do not use beano to tx), diarrhea, abdominal cramps
Alpha-glucosidase inhibitor associated with elevation of LFT’s
Acarbose
MOA of nateglinide
Closes K+ channel –> rapid and transient insulin release
Biguanide
Metformin
Drugs available in combination with metformin
Acroplus Met progutazone and metformin, Janumet and Janumet XR Sitagliptin and Metformin, Glyburide, glipizide, and rosiglitazone
MOA of metformin
Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
Weight loss*
Most important potential SE of metformin
Lactic acidosis = CI in renal failure
Can also exacerbate CHF
Meglitinides
Repaglinide
Nateglinide
MOA of repaglinide
Short acting insulin analogue –> Insulin release from pancreas
Faster and shorter acting than sulfonylurea
Less hypoglycemia than metformin
First generation sulfonylurea
Chlorpropamide, tolbutamide, tolazamide, etc.
Second generation sulfonylurea
Glyburide, glipizide, glimepiride, etc.
MOA of sulfonylureas
Close K+ channel –> Depolarization –> Ca influx –> insulin release
Common SE of sulfonylureas, repaglinide, and nateglinide
Hypoglycemia
Sulfonylurea NOT recommended for elderly because of very long half life
Chlorpropamide
Thiazolidinediones
Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)
Reason troglitazone was withdrawn from market
Hepatic toxicity
